Efficacy of an eConsult Service to Cure Hepatitis C in Primary Care

Jacey Nishiguchi; Anusha McNamara; Colleen S. Surlyn; Kellene Vokaty Eagen; Laura Feeney; Vivian Lian; David E. Smith

Disclosures

J Viral Hepat. 2022;29(1):21-25. 

In This Article

Results

A total of 1044 patients were prescribed a DAA. Of those, 456 patients met inclusion criteria (242 in the eConsult group and 214 in the non-eConsult group). The baseline characteristics of patients treated with or without an eConsult differed significantly by sex, race, prescriber type, and medication type in the ITT population (Table 1). A greater proportion of males were treated with an eConsult. Fewer patients who identified as Black were treated with an eConsult. In the PP population only prescriber type and medication type varied significantly. In the PP and ITT populations, there was a greater number of patients whose treatments were prescribed by nurse practitioners or physician assistants in the eConsult group, while the non-eConsult group had a greater number of prescribers who were physicians. Both populations also had a greater number of patients who were treated with glecaprevir/pibrentasvir (GLE-PIB) in the eConsult group, while other medication options were more commonly used in the non-eConsult group.

Use of the eConsult system was not associated with a significant difference in achieving SVR12 in either the ITT or PP populations. 92.3% of patients in the ITT population achieved SVR12, while 97.6% of patients in the PP population achieved SVR12. The rate of acceptance of eConsult treatment recommendations was 90.5%, excluding eConsults that involved issues other than requests for HCV treatment recommendations such as questions regarding timing and interpretation of laboratories, treatment interruptions, and medication side effects. Majority of eConsults submitted by PCPs requested treatment recommendations, while approximately 20% of eConsults were to confirm treatment regimens providers already had in mind. Of the requests for confirmation, nearly all were concordant with current guidelines and were aligned with the eConsult team's recommendation. Exceptions to this were situations in which an alternate medication was recommended by the eConsult team due to insurance issues.

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